Surgery in Pediatrics
EVERYONE whose child must be operated upon is indebted to those surgeons who have shown the way. Timothy Holmes and Samuel W. Kelley, whose texts appeared in 1869 and 1909 respectively, were the early leaders in the field. The more modern pioneers are Sir Lancelot Barrington Ward, William E. Ladd, Willis J. Potts, and Robert E. Gross. These men and their many brilliant students have demonstrated that operations of tremendous complexity can be performed successfully regardless of the small size of the patient.
Great medical advances in anesthesia, antibiotic therapy, and in the understanding of fluid and electrolyte administration have kept pace with the development of surgical technics. They have made the application of such technics possible. Progressive sharpening of the diagnostic abilities of the physician, particularly evident in the field of congenital heart disease, has also led to greater success and lessened mortality in the surgery of childhood.
In the early part of this century, Samuel W. Kelley, Orthopedist and Pediatrist of St. Luke's Hospital in Cleveland, could encompass in his time all that was known of the surgery of every region of the body of the child. The days of such great general surgeons are past. Knowledge in the surgical specialities has become far too extensive to be mastered by the individual. The surgeon who would limit his activities to an age group must find his niche in a large pediatric hospital, and in general his field is increasingly confined to surgical disease of the abdomen. From his . . .